"What is truly scary, what is truly risky, is to do nothing," Obama said, noting that premiums paid for health care coverage were rising three times faster than wages and that the government-run Medicare program for senior citizens would run out of money within a decade.

Third, government workers don't pay taxes. They consume taxes. The fact that there is a deduction on their paycheque does not change the fact that they are net recipients of taxes. That doesn't make them any less of a citizen, but it is a fact.

If you want someone to train to be a fire fighter, an administrator or a soldier you will have to offer them financial carrots. Otherwise no one would ever work for government. There are few self sustaining governments on the planet. All of them have massive oil revenue.

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

But this approach can also mask the signs that their condition is improving, the experts warn.

As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.

Yeah, if they would live they would then win a marathon and gold medals in free style, invent the CryPhone and make 40 more kids.
or:
most of these people will never have any kind of life again other than hooked up to machines, which makes hospitals, doctors and pharmas tons of $.

Just 50-70 years ago people were still allowed to die of trivial stuff like old age and the shutting down of all internal organs, good times....

Yeah, if they would live they would then win a marathon and gold medals in free style, invent the CryPhone and make 40 more kids.
or:
most of these people will never have any kind of life again other than hooked up to machines, which makes hospitals, doctors and pharmas tons of $.

Just 50-70 years ago people were still allowed to die of trivial stuff like old age and the shutting down of all internal organs, good times....

While I agree that there is no shame in dying of old age I feel the need to ask why you or anyone else are the one to judge whether their life is worth saving?

Your answer was a bit cold and could easily be construed by some as what the so-called "death panels" would say. There is more to a person than what you or society might get out of them...

NoahJ"It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err." - Mahatma Gandhi

Well, assuming that the individual can't offer up his or her own position, someone has to judge.

Family would be first, along with their doctor. Beyond that someone making a statement like Stinkbug who know nothing about the medical case and has never seen the patient is not the person. Citing statistical probabilities to facilitate ending a life, or stopping medical treatment, does not sit well with me.

NoahJ"It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err." - Mahatma Gandhi

While I agree that there is no shame in dying of old age I feel the need to ask why you or anyone else are the one to judge whether their life is worth saving?

Your answer was a bit cold and could easily be construed by some as what the so-called "death panels" would say. There is more to a person than what you or society might get out of them...

How do you read judgment into my post?

You promote keeping people alive on the off chance that they could recover. You are the one who wants to judge based on an opinion by a for profit medical industry.

Maybe I am one of the older people on this board. We have lost my parents and in laws and friends already. You may think it's cold but my dad wanted to die and had already said goodbye to everyone. However he was kept alive for another 9 month after his stroke. Unable to deal with his condition, my mother died before him. He never knew she died. It would have been much easier on everyone could he have had HIS will.

I am for dignity. A person who feels that the reaper is knocking and people do know this, should be allowed to leave this earth.

Family would be first, along with their doctor. Beyond that someone making a statement like Stinkbug who know nothing about the medical case and has never seen the patient is not the person. Citing statistical probabilities to facilitate ending a life, or stopping medical treatment, does not sit well with me.

Why are the family qualified to make that decision?

Gangs are not seen as legitimate, because they don't have control over public schools.

For instance, what if the family doesn't like the ill person very much? What if the ill person has all the money and their death would means profit for family members making the decision?

What if the ill person is homosexual and has been shunned by "family" all of their life, but that person's life partner is ignored when it comes time to make end of life decisions?

What if the doctor in question is a stake holder in the medical organization that stands to make a great deal of money by providing ongoing extraordinary measures to prolong the life of the terminal and catatonic?

They spoke of the sayings and doings of their commander, the grand duke, and told stories of his kindness and irascibility.

For instance, what if the family doesn't like the ill person very much? What if the ill person has all the money and their death would means profit for family members making the decision?

What if the ill person is homosexual and has been shunned by "family" all of their life, but that person's life partner is ignored when it comes time to make end of life decisions?

What if the doctor in question is a stake holder in the medical organization that stands to make a great deal of money by providing ongoing extraordinary measures to prolong the life of the terminal and catatonic?

What are the health care costs in the last year of ones life?

What are the health care costs in the next to last year of ones life?

In other words working backwards from death, what are the per capita health care costs, on an annualized basis.

We have an aging demographic, and very expensive medical technologies available today, that were virtually nonexistent just a century ago.

The Medicare tax rate is 2.9% (self) or split 50-50 between self and your employer.

Medicare is the 800 lb gorilla in the room according to GAO.

Every eye fixed itself upon him; with parted lips and bated breath the audience hung upon his words, taking no note of time, rapt in the ghastly fascinations of the tale. NOT!

You promote keeping people alive on the off chance that they could recover. You are the one who wants to judge based on an opinion by a for profit medical industry.

Maybe I am one of the older people on this board. We have lost my parents and in laws and friends already. You may think it's cold but my dad wanted to die and had already said goodbye to everyone. However he was kept alive for another 9 month after his stroke. Unable to deal with his condition, my mother died before him. He never knew she died. It would have been much easier on everyone could he have had HIS will.

I am for dignity. A person who feels that the reaper is knocking and people do know this, should be allowed to leave this earth.

All I promote is that life is worth more than what others are perceived to get from you.

Did your father have a will written down that stated that? If he did, then it should have been respected. Sorry that he had to go that way if it was not his wish.

We have recently (in the past few years) lost my wife's father to a liver disease and we are currently losing her mother to Alzheimer's (which is almost worse, there but not) so I am no stranger to death. It is definitely very hard on those left behind.

NoahJ"It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err." - Mahatma Gandhi

For instance, what if the family doesn't like the ill person very much? What if the ill person has all the money and their death would means profit for family members making the decision?

What if the ill person is homosexual and has been shunned by "family" all of their life, but that person's life partner is ignored when it comes time to make end of life decisions?

What if the doctor in question is a stake holder in the medical organization that stands to make a great deal of money by providing ongoing extraordinary measures to prolong the life of the terminal and catatonic?

What if?

NoahJ"It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err." - Mahatma Gandhi

In those instances family members and doctors may not be the best people to have making life and death decisions.

Certainly being being "family members" in no way guarantees having the best interests of the patient at heart.

By reflexively putting "family members" ahead of "best practices as understood by society and having been arrived at by medical doctors, ethicists, and those experienced in palliative care", which after all is what this is all about, you could well be condemning some of the ill to excessive or insufficient measures taken on their behalf.

I realize that this may happen now, my point is that, say, the hysteria over "government intervention" in end of life decisions is grossly overblown, giving the existing system of economic self interest.

You think "the doctor" is never influenced in his estimation of what, if any, extraordinary measures might be taken, by his estimation of the effected parties ability to pay?

They spoke of the sayings and doings of their commander, the grand duke, and told stories of his kindness and irascibility.

Who would you like to make the decision for you if you were put in that position and had not written it down?

Family Members

Doctors (such as your family doctor or your attending physician)

Strangers, Including but not limited to:
Insurance Reps
Bureaucrats

I picked the one I would like to see chosen.

My question is pretty simple. Why is the family the best choice to make this decision? They're often burdened with loads of emotional baggage (for good or ill, as adda's post suggests). They're sometimes desperately trying not to let someone go and are willing to ask that heroic measures be taken even if it will only prolong a terrible quality of life for a few weeks. What is the cost of that prolonging? Not just to them, but services that could be used elsewhere? Rooms? Doctor time? Nursing time? Orderly time? At what point does someone's inability to accept the fact that a loved one will die impinge on services that I might want or need? Is this, in the end, a kind fo zero-sum game?

Questions are fun!

Gangs are not seen as legitimate, because they don't have control over public schools.

They are the most likely to be aware of - and follow the desires of - the person in need of care. Flights of fancy aside, a bureaucracy doesn't care for individuals, and has no capability to address the needs of individuals. It creates categories and administrates those categories...people are just numbers, members of whatever category they fall into.

They are the most likely to be aware of - and follow the desires of - the person in need of care. Flights of fancy aside, a bureaucracy doesn't care for individuals, and has no capability to address the needs of individuals. It creates categories and administrates those categories...people are just numbers, members of whatever category they fall into.

They are the most likely to be aware of - and follow the desires of - the person in need of care. Flights of fancy aside, a bureaucracy doesn't care for individuals, and has no capability to address the needs of individuals. It creates categories and administrates those categories...people are just numbers, members of whatever category they fall into.

I'm surprised to learn that for-profit hospitals don't have bureaucracies and simply follow the wishes of families, regardless of their ability to pay.

They spoke of the sayings and doings of their commander, the grand duke, and told stories of his kindness and irascibility.

In those instances family members and doctors may not be the best people to have making life and death decisions.

Certainly being being "family members" in no way guarantees having the best interests of the patient at heart.

By reflexively putting "family members" ahead of "best practices as understood by society and having been arrived at by medical doctors, ethicists, and those experienced in palliative care", which after all is what this is all about, you could well be condemning some of the ill to excessive or insufficient measures taken on their behalf.

Honestly, the only person that can make the best decision for what the patient wants is the patient themselves. Short of that, the family members are usually aware of what the persons wishes are. Whether they choose to follow them or not is up to them and is not anyone elses place to tell them otherwise but the patient himself. If the patient leaves written instructions then that is as good as can be hoped for. Those "best practices as understood by society and having been arrived at by medical doctors, ethicists, and those experienced in palliative care" sound good on the outside, but they have their shortcomings as well. As would anything that is designed to be one size fits most.

Quote:

I realize that this may happen now, my point is that, say, the hysteria over "government intervention" in end of life decisions is grossly overblown, giving the existing system of economic self interest.

I am not talking specifically about government intervention, I am talking about any outside intervention by anyone that is not the patient or immediate family.

Quote:

You think "the doctor" is never influenced in his estimation of what, if any, extraordinary measures might be taken, by his estimation of the effected parties ability to pay?

Outside individual, closer to the patient and hopefully takes his Hippocratic oath seriously. The amount it costs "should not" influence his decision, and honestly even that should be left up to someone other than the doctor to decide to intrude about (send in the bureaucrats). One way or another an outside force will be involved in the health care when you reach that stage.

NoahJ"It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err." - Mahatma Gandhi

My question is pretty simple. Why is the family the best choice to make this decision? They're often burdened with loads of emotional baggage (for good or ill, as adda's post suggests). They're sometimes desperately trying not to let someone go and are willing to ask that heroic measures be taken even if it will only prolong a terrible quality of life for a few weeks. What is the cost of that prolonging? Not just to them, but services that could be used elsewhere? Rooms? Doctor time? Nursing time? Orderly time? At what point does someone's inability to accept the fact that a loved one will die impinge on services that I might want or need? Is this, in the end, a kind fo zero-sum game?

Questions are fun!

I think I covered this in my previous response to addabox...

Costs do not matter to me, I do not put a price on human life, others may, and usually do however. I will not pay thousands for a dog's to be prolonged as it is simply an animal, but a person, that is another issue. Especially if I know that person wants to live as long as possible. Placed in the position might change my mind, but I don't believe it will. I would only make the decision to pull the plug if I felt certain I had exhausted every other ethical option for recuperation.

NoahJ"It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err." - Mahatma Gandhi

Costs do not matter to me, I do not put a price on human life, others may, and usually do however.

So you're saying that if, for instance, it required every resource in a hospital working entirely on a single patient for 3 weeks to sustain the life of a single person for 10 minutes, you'd be OK with that?

Gangs are not seen as legitimate, because they don't have control over public schools.

Are you saying you don't remember the GOP attempting to stop the husband from pulling the plug on his vegetable wife over the objections of her family, who were hell-bent on keeping her "alive"? Do you not remember Bill Frist diagnosing her from a video on the floor of the senate? Are you saying that this is not a perfect example of how the family is very often not the best place for this decision to be made?

Gangs are not seen as legitimate, because they don't have control over public schools.

Are you saying you don't remember the GOP attempting to stop the husband from pulling the plug on his vegetable wife over the objections of her family, who were hell-bent on keeping her "alive"? Do you not remember Bill Frist diagnosing her from a video on the floor of the senate? Are you saying that this is not a perfect example of how the family is very often not the best place for this decision to be made?

Are you saying he was not aware of nor followed his wife's wishes?

The political drama is not interesting to me.

NoahJ"It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err." - Mahatma Gandhi

So you're saying that if, for instance, it required every resource in a hospital working entirely on a single patient for 3 weeks to sustain the life of a single person for 10 minutes, you'd be OK with that?

Now you are stacking one human life up against many others. Is one life worth the cost of possibly dozens of others. A much harder question. Also, not a realistic scenario. If you were working on the person for 3 weeks, then you would have gotten at least 3 weeks 10 minutes out of it.

However to give a more direct answer, look to my last statement: I would only make the decision to pull the plug if I felt certain I had exhausted every other ETHICAL option for recuperation. Is it ethical to rob the life of other patients to keep my loved one alive?

NoahJ"It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err." - Mahatma Gandhi

Now you are stacking one human life up against many others. Is one life worth the cost of possibly dozens of others. A much harder question. Also, not a realistic scenario. If you were working on the person for 3 weeks, then you would have gotten at least 3 weeks 10 minutes out of it.

However to give a more direct answer, look to my last statement: I would only make the decision to pull the plug if I felt certain I had exhausted every other ETHICAL option for recuperation. Is it ethical to rob the life of other patients to keep my loved one alive?

So you're for health care rationing, then?

They spoke of the sayings and doings of their commander, the grand duke, and told stories of his kindness and irascibility.

How so? The way we allocate health resources now is rationing via income. If you have enough money, you can be kept alive as long as your family wishes. Maybe a miracle will happen. If you don't have enough money, well, somebody else needs the bed.

Isn't that saving the few at the expense of the many? Wouldn't a system based on reasonable expectations of outcome, and which made reasonable efforts available to one and all, be more just and equitable?

You talk about "families" and "choice" as if that were self evidently right and proper, but the fact is, now, today, many many families don't really have any choice at all. Even for the insured, prolonged illness can run through lifetime caps and exhaust resources before any decision about "extraordinary measures" every gets made, and at that point there may be no decision left.

What does it even mean to speak of "exhausting every ethical option for recuperation" when options cost money?

They spoke of the sayings and doings of their commander, the grand duke, and told stories of his kindness and irascibility.

Frankly, there are enough resources in this world to keep everyone fed, housed, and reasonably healthy. Unfortunately the bulk of the resources are concentrated so that few have access to them. If you really think about it, so many of our problems today exist because in our global economy, the driving force is to find new and innovative ways to fuck someone else out of his or her money. Greed is not good, Gordon.

Medical insurance companies make money by finding creative ways to deny their very own product to their paying customers in times of need. Ho do you not see that conflict of interest there?

And it's high time we take our collective heads out of our asses and stop it with this nonsensical us and them mentality. We're one people on one planet in a vast and lonely universe. Get over it. Until everyone can lead a comfortable existence and we can collectively venture out into the cosmos, no one should be satisfied. I want all of you to have food, shelter, safety, and good health. That even goes for you assholes who don't want the same for everyone else. And yes, I mean you. And you. And you. Not you. But definitely you.

“The nitrogen in our DNA, the calcium in our teeth, the iron in our blood, the carbon in our apple pies were made in the interiors of collapsing stars. We are made of starstuff.” -Sagan

Frankly, there are enough resources in this world to keep everyone fed, housed, and reasonably healthy.

I make an effort to provide just that - food, shelter and health care - for myself and my family. It takes 40 hrs a week, going on for close to 40 years now. Are you suggesting I need to make that effort for folks that don't?

All the resources in the world are there, the effort to extract them from the environment isn't, and if folks don't provide for themselves in the same manner I do, then what should motivate me to do for them what they won't do for themselves?

I want the same for everyone else. I want all of them to have food, shelter, safety, and good health. If they work hard and earn their way, they can have it.

Are you saying that you don't remember that his wife's family would not allow him to pull the plug because they couldn't let go? Are you saying that you don't remember this was all over the courts? Are you saying that you haven't bothered to google this?

Gangs are not seen as legitimate, because they don't have control over public schools.

Now you are stacking one human life up against many others. Is one life worth the cost of possibly dozens of others. A much harder question. Also, not a realistic scenario. If you were working on the person for 3 weeks, then you would have gotten at least 3 weeks 10 minutes out of it.

However to give a more direct answer, look to my last statement: I would only make the decision to pull the plug if I felt certain I had exhausted every other ETHICAL option for recuperation. Is it ethical to rob the life of other patients to keep my loved one alive?

You claimed that you don't put a price tag on human life. I was providing you an (extreme) scenario in which it is pretty clear that you would put a price on it. Is this not true? Would you not put a price on a human life in a situation like this? Is there not a point at which the amount of effort to sustain the life simply is not worth the amount and quality of life that would be sustained?

Questions are fun!

Gangs are not seen as legitimate, because they don't have control over public schools.

You claimed that you don't put a price tag on human life. I was providing you an (extreme) scenario in which it is pretty clear that you would put a price on it. Is this not true? Would you not put a price on a human life in a situation like this? Is there not a point at which the amount of effort to sustain the life simply is not worth the amount and quality of life that would be sustained?

Questions are fun!

Life for life, seems cost neutral. Pretty soon you will be trying to get me to tell you if one person is worth more than another, or many others. Then do we get to go into what makes them worth saving over the other person or persons?

Not gonna go any further down this rat hole you are trying to construct...

I would only make the decision to pull the plug if I felt certain I had exhausted every other ETHICAL option for recuperation. Is it ethical to rob the life of other patients to keep my loved one alive? (Seems to cover your question before you even asked it.)

The last part of my statement is my introspection and I clearly cannot answer it when not in the situation. You are not going to force me to pretend I know what I will say the day that comes. Nor are you going to take away my ability to choose. Also bear in mind, there will be others also looking out for their patients, so the decision will not be made in a vacuum.

That is my answer and as far as I should need to go in this part discussion.

NoahJ"It is unwise to be too sure of one's own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err." - Mahatma Gandhi

Life for life, seems cost neutral. Pretty soon you will be trying to get me to tell you if one person is worth more than another, or many others. Then do we get to go into what makes them worth saving over the other person or persons?

That's not at all what I'm trying to get you to do. You presented a fairly idealistic claim that you don't place a value on human life. I'm suggesting that, in fact, you do. That everyone would. It's not something we'd like to admit, and it's something that we can only claim we don't do if we are given unlimited resources devoted solely to us. But in the end, given limited resources and the ethical concerns of removing services from others in order to sustain a poor quality of life for a brief amount of time, we all would work this calculus.

Quote:

I would only make the decision to pull the plug if I felt certain I had exhausted every other ETHICAL option for recuperation. Is it ethical to rob the life of other patients to keep my loved one alive? (Seems to cover your question before you even asked it.)

Is it? That's the question I asked you.

Quote:

The last part of my statement is my introspection and I clearly cannot answer it when not in the situation. You are not going to force me to pretend I know what I will say the day that comes.

I can't force you to do anything. But I can wonder at why you refuse to examine the ethics and economy of a hypothetical situation while, just above this statement, you asked me the very same question.

Quote:

Nor are you going to take away my ability to choose.

To choose what?

Quote:

Also bear in mind, there will be others also looking out for their patients

Quote:

That is my answer and as far as I should need to go in this part discussion.

But you didn't answer anything beyond saying "I'd pull the plug if all other ethical options were exhausted." That's not the question.

I asked "So you're saying that if, for instance, it required every resource in a hospital working entirely on a single patient for 3 weeks to sustain the life of a single person for 10 minutes, you'd be OK with that?"

You answered my question by correctly sussing out the ethical issue at the heart of it and then restated the question. Then you refused to engage the very same question I'd led you to while asking me the very same question.

And now we're all meta.

Soooo.

Would it be ethical to demand that an entire hospital devote every resource for an extended time in order to the preserve a poor quality of life for a brief amount of time?

Gangs are not seen as legitimate, because they don't have control over public schools.